Describe preterm human milk's protein concentration and fortification needs.

• A. Preterm milk has low protein that remains constant; fortification unnecessary
• B. Preterm human milk often has higher protein concentration which decreases with lactation; fortifiers are needed to meet protein, calcium, phosphorus and sodium needs
• C. Protein levels are irrelevant to fortification
• D. Protein concentration is lower and increases with lactation; fortification is optional

Answer: (B)

Preterm human milk is structured to meet the rapid growth needs of very small babies. In the early days after birth it often has a higher protein concentration than term milk, but this protein level declines over time as lactation continues. Because preterm infants require more protein and minerals (such as calcium, phosphorus, and sodium) than term infants to support growth and bone mineralization, unfortified human milk may not provide enough of these nutrients. That’s why fortification is typically needed, to raise protein intake and supply essential minerals. Fortification strategies vary, but the underlying principle is to compensate for the higher nutrient needs of preterm infants by adding protein and minerals to the milk.